I need advice, encouragement, suggestions, etc. for my current situation--
let me first summarize my situation, then make a list of questions and
comments, followed by some detail info, which you may not want to read.
Would like people to comment --from those who have similar situation and
survived (what they did, what works for them, etc.) as well as those in the
medical field (unfortunately, those similar to me who did not survive will not
be able to contribute, but perhaps their spouse/family/friend could comment)
Any suggestions on experimental drugs/treatment would be welcome, especially if
these have brought some good result.
-------------synopsis of my current situation -------------
6 weeks after my robotic prostate removal surgery on my 65th birthday (October
9 2009), my PSA level was found to be 7 and 6.4 (retest).
The next steps (my surgeon requested) bone scan; followed by CT scan fused with
prostascint (look for soft tissue metastasizes); then hormone treatment (Lupron)
which will hope to keep cancer at bay for 5-8 years (IS THAT REALISTIC ??).
Option of radiation treatment at prostate site 6-9 month from now (WHY NOT
SOONER ?? he said to wait till recovery, including incontinence/impotence/etc.
). Is that the best treatment ??
My prostate surgery was due to Gleason 7 (4+3) biopsy on Aug., 2009 triggered
by a 4.2 reading in April 2009, on PSA (doubling time of ~2 years, I
believe). The PSA just before surgery was 6.7.
The surgery post-mortum was Gleason 7 (4+3), T3b, right seminal vesicle
cancerous (removed), Surrounding tissues removed. Adjacent lymph nodes removed
but not cancerous. (I sort of wish that once spreading was confirmed, he could
have switched to open surgery to remove more surrounding tissues and to examine
a larger area--but that was not done; I thought that this switching is fairly
common, correct or not ??). Of course, if there were global spreading, then
this would not have helped.
---------------------Questions, request for comment -----------
(0) Is Lupron the best avenue for me right now ?? Should I have radiation
treatment ASAP (Impotence is not important for me ) ?? Are there any other
better options ?? are there experimental treatment/drugs that I could partake
(1) I guess robotic choice may have been a mistake. From my web investigations
--many hours; Google is very frustrating to use, giving 80+% useless links with
general repeated info, and only a few good sites, which one have to skip to the
important parts --prior to surgery, Robotic is recommended for Gleason 6 but
for Gleason 8-10, Ope is recommended (for the reason like muy case) but Gleason
7 if in the borderline. I should have realized that 4+3 =7 Gleason is actually
like Gleason 8 --and opt for Open. BTW, Radiation would likely have been a bad
choice, since it will likely not remove the cancer in my seminal vesicles (is
that correct). Of course, Global spreading might have taken place, so it
probably did not matter.
(2) My wife berated me for waiting 7 weeks to do surgery after the biopsy
results --and claimed that the spreading might have been due to the
waiting--but my surgeon said that almost certainly the spreading occurred at
least 6+ months (perhaps even years) before the biopsy. Is he right (or is my
wife). Actually, it took me one week to make up my mind, the I scheduled it for
the first available slot, which was in 6 weeks. My medical treatment was
thorough a large (200+ physician) medical group with my HMO--and I had been up
to now quite satisfied with my medical experience. Should I look outsode for a
2nd opinion and perhaps treatment ?? Can someone recommend someone/somewhere in
the Chicago suburbs or perhaps the city ??
-----some more details ---------
(1) I have a family history of Prostate and other cancer --My father and his 2 brothers all have cancer. Father had it at 85 (watchful waiting) and died at 90 not of Prostate cancer. Middle brother had brain cancer at 62 and died a long time ago. Youngest brother had cancer at 75 (Gleason 6), radiation treatment, and is doing fine after 4 years. My 3-year older brother is so far fine.
(2) I have other medical problems --high cholesterol (family) controlled by statins (Zocor/Lipitor/Simvastatin) since 10 years. Pre-diabetes controlled by Metformin since 4 years (A1c 6 to 7). Otherwise reasonably healthy but overweight (I do do exercises, and try to eat healthy).
(3) Incontinence recovery is slow (some control, but still on diapers and
pads). BM is fine (thank G...). Impotence not yet recovered (but not important for me) .
(4) PSA history 0 (2000), 2.6 (5/06), 3.6 (5/08), 3.9 (12/08), 4.2 (4/09),
6.7 (10/09)--after Cancer diagnosis. Based on the 4.2 PSA, my primary doctor refer me to a urologist because he does not like the velocity (doubling rate of about 2 years) --which lead to a biopsy and Gleason 4+3=7 diagnosis of Prostate cancer (2/12 samples, one left and one right(69% mostly 4).